Cellulite, a term coined by Nicole Ronsard in the 1970's (see Webster's New Universal Unabridged Dictionary, 2nd ed. Dorset & Baber 1983) describes a widespread condition in which abnormal subcutaneous deposits of irregular fatty masses produce unsightly disturbances in the skin's normally smooth curvatures.
Physiologically, cellulite is caused by a degeneration of the micro circulation in areas of the body prone to fatty deposits. Severe cellulite is characterized by degeneration of subcutaneous blood vessels, poor blood flow, a thinning of the epidermal and dermal layers of the skin, the presence of hard lumps of fatty material surrounded by protein in the subcutaneous regions, and an accumulation and pooling of body fluids. The result in the skin taking on an "orange peel" appearance.
Cellulite is most commonly problematical on the thighs, buttocks and upper arms, less so on the outer limbs, back, torso and midriff and is not usually significant on the face, neck, hands and feet. While often associated with obesity, cellulite may also manifest itself in the skin of individuals of normal or near-normal weight. It is more prevalent on females than males and more apparent on Caucasians than darker skinned individuals.
Detracting greatly from an individual's appearance, cellulite can have profound psychological effects, damaging the self-esteem of many afflicted individuals and perhaps seriously undermining the healthy psychological development of some young women and men. There is, accordingly, a great need for effective cellulite remedies.
Known methodologies for cellulite treatment include localized mechanical action, topical application of chemical agents, exercise, dietary adjustments, and combinations of these therapies. One effective treatment is a combination of diet and exercise, rigorously maintained over an extended period. Many people seek easier remedies. As I have verified, by clinical tests described herein, known easily applied topical treatments provide only superficial benefits and fail to improve structural defects significantly.
Stewart U.S. Pat. No. 4,829,987 teaches a cellulite treatment requiring the application of a mineral-solution-soaked wrap to an appropriate body portion, followed by passive exercise of that body portion. This treatment would be too inconvenient or demanding for many people.
Massage improves microcirculation and stimulates exfoliation, smoothing the skin surface and increasing blood flow, but only temporarily. Henderson U.S. Pat. No. 4,086,922 discloses a massage device and method for treating cellulite. The device comprises multiple resiliently loaded balls that are applied to massage afflicted body areas.
Heat treatment also stimulates microcirculation and may provide temporary benefits, but no long-term structural improvements.
Body lotions, tonics and creams containing supposedly active biologicals, for example, witch hazel, broom, horse chestnut, algae, sea water or escine, may provide temporary, mild microcirculatory stimulation but are at best modestly active.
The aforesaid massage, heat treatment and biological formulations do not address problems of skin renewal, fat catabolism, body fluid accumulation or the regeneration of blood vessels.
Diuretics, (botanicals are usually preferred), promote lymphatic drainage, yielding good short-term symptomatic effects but do not address long-term skin defects, fat catabolism or blood vessel regeneration.
Caffeine, theophylline and other xanthines, appear to be effective, in high concentrations, as diuretics and also in promoting fat catabolism. Aminophylline, currently a popular active ingredient in what are known as thigh creams or thigh-smoothing creams, appears to be effective as a powerful diuretic in promoting lymphatic drainage but is reported to have significant toxic side effects (see The Merck Index eleventh edition, Merck & Co. Inc. 1989 monograph number 477). Such agents do not address underlying structural defects of the skin and blood vessels.
Some cosmetic compositions incorporating modified caffeine derivatives as active agents are described in Trebosc et al. U.S. Pat. No. 5,030,451. According to Trebosc et al., column 9, lines 15-20, the disclosed formulations have
"excellent and long-acting `lipolytic properties` and have therefore proven very effective in slenderizing programs and in the treatment of cellulitis."
However, no efficacy data is reported. At column 1, lines 61-65, Trebosc et al. teach that a faster rate of transcutaneous passage confirms the superiority of these agents in the treatment of cellulite.
Mausner U.S. Pat. No. 5,215,759 references the use of methylsilanol theophyllinacetate alginate and methylsilanol mannuronate for anti-cellulite activity. Lacking explanatory disclosure, the action of these substances is presumably equivalent to diuretics.
One drawback to marketing stimulant compositions (containing caffeine, aminophylline or related agents as active ingredients) for consumer treatment of cellulite, is that drug issues may be raised preventing their being included in cosmetic compositions for over-the-counter sale. Repeated long-term use may induce harmful side effects, and government regulations may limit marketability. Another drawback is that such agents fail to address underlying structural problems of skin and blood vessel defects.
Exfoliating granules act mechanically, abrading the outer layers of the skin, smoothing the skin surface and promoting skin renewal, but fail to promote lymphatic drainage, long-term microcirculatory regeneration or fat catabolism. Exfoliating granules are hard particles, generally suspended creams or gels, that are rubbed or massaged on the skin to achieve a mechanical exfoliation. The granules are usually polyethylene spheres, however natural particles like peach or apricot crushed pits have been used. A further drawback of these products is that it is hard to control irritation.
Topically applied retinoids, for example, as disclosed in Kligman U.S. Pat. No. 5,051,449, can ameliorate cellulite to a limited extent. Kligman gives qualitative reports of comparative benefits obtained after more than six months of topical applications of a retinoic acid preparation, versus an unidentified non-medicated "purpose" cream. These benefits are described as including skin thickening, an increase in the number of new blood vessels, and an observable moderate-to-marked improvement (of cellulite) using a pinch test (column 6, lines 50-61). No quantitative data are given so that the value of Kligman's teaching for treating cellulite cannot be determined by one skilled in the art.
Many people want and expect greater efficacy from a cellulite treatment than is provided by moderate improvements after six months of treatment. Applied concentrations of retinoic acids must be limited to avoid inducing irritation (see Kligman column 2, lines 59-60), so that adequate efficacy cannot be achieved by increased dosages. Thus retinoic acid treatments do not provide a satisfactory long-term treatment for cellulite and there is a need for more effective topical treatments. In contrast to Kligman's unsubstantiated generalizations, I have found in quantified clinical studies that retinoic acid provides no significant skin thickening after three months of daily treatments. Accordingly, there is a need for an easily applied cellulite treatment which provides structural improvements in a reasonable period of time.